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Alabama rates for HCPCS 97163

Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $95 · 10th–90th $54–$950%20%40%10th$95Professionalmedian $76 · 10th–90th $50–$1200%10%10th90th$76$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $95.50 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $75.86 / $125.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $58.88 / $79.43
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $95.50 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $70.79 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $95.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $77.62 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $74.13 / $104.71